Sarcomas are rare, primary mesenchymal tumors representing less than 1% of all malignant tumors. 10% to 15% are located in the retroperitoneum and are dominated by liposarcoma, which represents approximately 40 to 50% of retroperitoneal sarcomas [1,2].

Retroperitoneal liposarcoma affects both sexes equally. The average age at diagnosis is around the fifth decade, but the disease can affect all age groups. The slow increase in tumor volume and the compliance of the retroperitoneal space explain the tumor's long asymptomatic nature [1,2].

From an anatomopathological point of view, we rely on the AJCC classification based on size, grade, the depth of the tumor, and the presence or absence of lymphadenopathy or metastases. The clinical presentation is polymorphic and characterized by borrowed signs, depending on the region where the tumor develops and the stage of progression. Certain associated manifestations may be observed, such as multiple intramuscular or subcutaneous lipomas or scrotal liposarcoma.[3].

Laboratory tests do not contribute to the diagnosis; they sometimes reveal paraneoplastic hypercalcemia. Abdominal ultrasound shows a homogeneous hyperechoic mass displacing adjacent organs, allowing diagnosis in 30 to 50% of cases. Abdominopelvic tomodensitography is the key examination; it reveals a heterogeneous hypodense tumor, clarifies its relationship to adjacent organs, guides aspiration and biopsy, and allows for postoperative monitoring. Magnetic resonance imaging (MRI) can detect vascular invasion. Fine-needle aspiration cytology has been used by many authors; its limitations are the small amount of material and the experience of the pathologist. Percutaneous biopsy always carries the risk of seeding along the path of the biopsy needle [3,4,5].

The primary treatment is surgery. The excision must be complete and must extend into healthy tissue. A safety margin of two centimeters is considered optimal. If the patient underwent a preoperative biopsy, the excision will include the entry point of the biopsy trocar as well as the tract [3].

This surgery is often difficult due to the proximity of major blood vessels. Oncological imperatives sometimes necessitate organ sacrifice (kidney, spleen, tail of the pancreas) and vascular sacrifices (inferior vena cava, iliac artery or vein).

Sacrificing the infrarenal vena cava requires no additional procedures; however, arterial sacrifice necessitates reconstitution of the system Arterial [6,7].

In cases of metastases, adjuvant or neoadjuvant chemotherapy with doxorubicin is used. The course of the disease is characterized by very frequent local recurrences (40 to 90%), which justifies wide excisions and aggressive treatment.

A second resection is beneficial in cases of low-grade liposarcoma.

Poor prognostic factors include high grade, size greater than 5 cm, and age over 50 years. Myxoid liposarcoma has a better prognosis than other forms. Distant metastases can occur in the liver, pleura, and peritoneum. They are not common in liposarcoma, which has a higher tendency to recur. Very often, patients who undergo surgery for liposarcoma die from a recurrence [8,9].